Who are you completing this application for?
Are you able to work from home during your isolation period?
Will you have a reduction in earned income?
Are you currently in receipt of furlough pay?:
Are you in receipt of the Covid-19 Self-Employment Income Support Scheme grant from HMRC?:
Is there any other income coming into you household? (e.g. partner’s wages, pensions, income from property)
I agree to the above declaration: